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MySugr app and its Hb1AC estimates

Discussion in 'Diabetes Discussions' started by svgittins, Oct 17, 2019.

  1. svgittins

    svgittins Type 2 · Member

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    I thought I would put my own experience of estimating HbA1C via the glucose monitoring app MySugr. There has been a number of threads on this recently. But here are my own experiences to throw into the mix. I would be also interested to have feedback from those more experienced than me to suggest how I could get more realistic estimates from mySugr.

    I was diagnosed with T2 3 months ago in mid July this year. At this time I was almost certain I was diabetic and had already been making big diet and exercise changes for some weeks. My initial HbA1C reading though was a scary 117. I was immediately put on 850 mg metformin twice a day and also went on a fairly strict regime of exercise and diet (in 3 months I have lost about 8kg and my BMI has gone down from 32 to 27.5).

    I had taken my BG a few times before I got diagnosed and it was then around about 20 mmol/l (which is what got me to the doctor) . Some time after starting the metformin (early August) I started a regular monitoring of BG (using an Accuccheck Performa Nano) and tracking it with mySugr. Gratifyingly there was an immediate big drop in BG levels.

    Now I am not totally consistent when I take my BG reading - I usually do it first thing (which is often the highest reading), and then typically between 2 - 6 times a day, usually before and after meals (after meals its usually 1.5 - 2 hours after eating). Typical readings have been 5.5 - 6.5 mmol/l with a few much higher (I found hard physical exercise shoots BG right up for a couple of hours) and some lower (down to 4.7). The mySugr estimated HbA1C has been pretty consistently in the high 30s (today its 36.5). I admit I was sceptical at this figure as this was such a huge drop in a few weeks from my initial 1A1C test at 117, but I WAS hoping for something in the non-diabetic range as I read on the forums here about how quite a few people found good correlations between the mySugr HbA1C estimates and the actual tests.

    So I have now just had my first 3 month HbA1C test and the result has come through with a disappointing 51. Obviously it is great I have more than halved the reading from July but there is really a very big difference between this and the mySugr estimates. Now I am the sort of person who does like to monitor things - but clearly. I would like to get something closer to reality. Maybe I should take readings after meals much sooner? And maybe after having a snack? Suggestions?
     
  2. xfieldok

    xfieldok Type 2 · Well-Known Member

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    Firstly a massive congratulations on your number that is a considerable achievement.

    Mysugr is totally dependent upon the data you put in. If you miss a few readings it will impact the estimated hba1c. The more readings, the more accurate.

    Having said that, it is unlikely to be exactly the same as a lab test. Use it to spot trends. When I first started using it it gave me an estimated hba1c of 37 after 4 months. An a1c test gave me me 35. Close enough for me.

    I went keto straight away and was a bit anal about testing, but it was worth it.
     
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  3. Rachox

    Rachox Type 2 (in remission!) · Moderator
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    If I have understood your post correctly, you were diagnosed three months ago, but have only been entering your blood sugars into MySugr for around two months. That would mean that the My Sugr estimate would have only been calculated from your more recent readings which because of your diet and exercise would be lower than the first month after diagnosis. this could explain the discrepancy. Well done by the way on halving your reading, that’s a brilliant result anyway!
    I have used MySugr since diagnosis and have found results to be within 4 of my lab results. The latest one from the lab was 32 whilst MySugr showed 29.2, this was on around 4 readings per day, always before and 2 hours after breakfast, then before and 2 hours after one other meal.
    Your next results should be closer together when you have input a full three months data.
     
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  4. ChrissiStar

    ChrissiStar Type 1 · Well-Known Member

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    First of all, that’s a brilliant result!

    MySugr has turned out pretty accurate for me, was estimating my hbA1c as 41.6 and my hbA1c today was 42, but then I have been intensively testing, so it had loads of data to work with.
     
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  5. svgittins

    svgittins Type 2 · Member

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    Thanks @xfieldok @Rachox and @ChrissiStar for your helpful comments! In fact I have been inputting into MySugr pretty well every day except for the first two weeks following diagnosis (so 10 weeks in all) and I have just checked - I have 387 logs which averages about 5 readings a day. I still think that divergence from estimated and actual hb1AC (50% error) is pretty huge given this. I guess I will try and be more disciplined in my sampling (I like @Rachox's regime - I think easy to follow).
     
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  6. JimPD

    JimPD Type 2 · Member

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    Used MySugr for just over a year. 4 or 6 tests/day. Before meals and +2 hours after
    Found it pretty close. Predicted 2 points lower than actual results pretty consistently.
    Also found it useful as a food diary to track carbs per day averages.
    Good App.
     
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  7. VashtiB

    VashtiB Type 2 · Well-Known Member

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    I've just had my first HbA1c review and the result was dead on the mysugr prediction. I think it may have been actually a bit lower except for the last two weeks of stomach wrenching stress from work.

    I think that at least part of it would be the old cells (more than 2 months old) who would have had your old levels still in them. I also think the more results you put in the better the prediction.

    But Congratulations! that is an awesome drop- if you keep on I'm sure your next test will be where it is predicted. You have achieved amazingly.

    You may want to try testing at 90 mins, 120 mins and 150 mins after meals to see where your spike is.

    Congratulations- I hope your dr was impressed.
     
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  8. svgittins

    svgittins Type 2 · Member

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    Here is a follow-up to my original post when I reported that MySugr was estimating my Hba1c ro be in the high to mid 30s but my HbA1c in mid October was 51. Since then I have been much more rigorous and frequent with my testing, as suggested on this forum, though I have also have reduced my carb input (previously I was on a low GI diet, now I have gone more-or-less keto, recently always less than 50 g carbs/day). MySugr is now reporting an even lower estimated HbA1C of 33.5. I have learnt that I do not appear to have big spikes. Even a backslide of eating pasta one evening some weeks ago pushed my BG to just 7.0 for a few hours. With these apparent contradictions I was sufficiently motivated to get a rather pricy (£47) private HbA1c test done exactly 2 weeks after my "official" one done via my GP. TThis second test had an HbA1C reading of 44 mmol/l compared to my 3 month GP check of 51. Now I initially thought this implied the GP test was possibly wrong, but on due reflection in my first 3 months my BG level came down by 5 mmol/l on average a week, so this might just be a natural reduction with a further two weeks of daily lower blood glucose. I live in hope that when I have my next official test (still well over 2 months away) that the mySugr and my HbA1C results are as close as the other posters here..
     
  9. Flora123

    Flora123 Type 2 · Well-Known Member

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    I have found that mySugr predicts higher than my eventual tests results. Predicted 40-41 and then test results at 36. This has happened three times now. However I have changed my meter and it is now predicting 35.4 so I expect the variation was down to my previous meter and inaccuracies there. During my switchover I tested with both meters and the new contour Next does test lower than my old Aga Matrix meter.
     
    #9 Flora123, Oct 31, 2019 at 2:56 PM
    Last edited: Oct 31, 2019
  10. svgittins

    svgittins Type 2 · Member

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    Updating this thread for the Greater Good:
    Here is a summery of my Hb1AC:
    117 - July 2019 (diagnosis)
    51 - October 2019
    44 - October 2019 (privately paid test done 2 weeks after previous one, as I did not trust the result - because of my own BG readings)
    38 - January 2019 (results posted on my GPs web site yesterday - I am yet to meet nurse to discuss them)

    I became much more rigorous about recording BG levels after interaction on this forum in October (as I did with the low-carbness of my diet). So while I am (obviously!) very pleased with my progress, the mySugr app has consistently estimated values for my HbA1C in the low to mid 30s - today's estimate is 34.2

    I am not totally sure what to conclude from this other than in my case the mySugr application consistently underestimates my A1Cs which is different to most other people who have reported. It may be my recording is not rigorous enough or perhaps I have more spikes than are typical. One thing I have found out relatively recently is that vigorous exercise (of which I do quite a lot) sends my BG right up (maybe 2 points up). Maybe I should be recording this?

    Anyhow, having said all, in my case I have really learnt the importance of self testing and am very relieved dietary control has worked so well for me.
     
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  11. xfieldok

    xfieldok Type 2 · Well-Known Member

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    How many times a day are you entering data? You can record exercise in mysugr.
     
  12. svgittins

    svgittins Type 2 · Member

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    @xfieldok I record typically 4 - 7 times a day and I HAVE now started recording exercise, but this is recent. But (thanks to other forum posters)I have realised what is significant is WHEN you record. First thing in the morning is easy, doing it before eating and 2 hours later is much more tricky when you are working and have other distractions (and I confess I am much better at remembering 1 hour after a meal rather than 2 hours).
     
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  13. jpscloud

    jpscloud Type 2 · Well-Known Member

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    I've been lazy recently but when recording enough data the predicted HbA1c fro MySugr was spot on.
     
  14. xfieldok

    xfieldok Type 2 · Well-Known Member

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    Set the alarm on your phone when you need to test, it's what I do.
     
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  15. VashtiB

    VashtiB Type 2 · Well-Known Member

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    Congratulations on your latest result- you must be happy with that. I hope the nurse is suitably impressed.

    If you are doing vigorous exercise and that raises your levels for a period that may well effect the HbA1c as that is an average.

    You have made a huge change in 6 months
     
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  16. Laconic

    Laconic · Well-Known Member

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    This is how I used to feel, I’ve decided not to obsess over HBA1C, just carry on low carbing and exercising. I’m losing weight and am certain I will reach non diabetic levels sooner rather than later

    However congratulations on the progress you have made
     
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    #16 Laconic, Jan 11, 2020 at 4:48 PM
    Last edited: Jan 11, 2020
  17. Robbity

    Robbity Type 2 · Expert

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    You're doing extremely well so far, so I wouldn't bother too much over differences between estimated and actual HbA1C results..

    There are things other that our reactions to food or exercise that can effect our glucose levels, and unless we use something like a Libre sensor for 24/7 readings we're going to miss other highs or lows, so I'm not sure that you'll ever necessarily get compatible values from estimates made from finger prick spot checks and the results from your HbA1C which is measuring your overall levels for the same period. As far as I'm concerned what I see from regular meter tests are what tell me how I'm doing and what I may need to watch or change, while longer term HbA1C averages actually give me very little useful information and are simply there for my DN and GP to monitor progress or lack thereof.

    My meter can give me finger prick averages and I use these figures with our diabetes.co.uk HbA1C calculator/converter to predict HbA1Cs and those figures I get are consistently lower than my actual results, but the patterns I see are consistent, and I think that's the best I'll get. But this means I can fairly accurately predict my actual HbA1C from my meter averages. Additionally, the 24/7 data from my Libre software has always given me much lower HbA1C estimates than those from finger pricks, though the actual patterns I see are still pretty consistent.

    And finally, to confuse issues further, HbA1C results may not be all that accurate anyway - @Bluetit1802 has had different results from (the same I believe) samples sent to different Labs. And I saw something similar when I had a second HbA1C check done in hospital before a minor operation, which was somewhat higher than the regular check done a few weeks beforehand at the surgery. o_O
     
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  18. Bluetit1802

    Bluetit1802 Type 2 (in remission!) · Guru

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    Yes indeed. The HbA1c test is not as reliable as we may imagine. There is an error tolerance in them (not sure what it is) and it depends on the lab and the type of machinery used. It also depends on the type of red blood cells each person has - and we are not all the same in this respect.
     
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